Community prevalence of at-risk state for bipolar disorder: Validation of the Korean version of Bipolar Prodrome Symptom Interview and Scale-Abbreviated Screen for Patients (BPSS-AS-P)

초록

Introduction The progression towards early identification and intervention of bipolar disorder (BD) has been dampened by a scarcity of reliable early screening instruments for BD risk. The Bipolar Prodrome Symptom Interview and Scale-Abbreviated Screen for Patients (BPSS-AS-P) is a self-rated questionnaire devised to screen individuals at risk of developing BD but has not been validated in a community-dwelling individuals. The current study aimed to validate its psychometric properties and determine the optimal cut-off in a community sample. Methods The study included community-dwelling residents, aged 14-34, who underwent two-phased, semi-structured interviews. Among those, 138 individuals who screened positive on the Mood Disorder Questionnaire (MDQ) participated in the second stage interview by a psychiatrist and completed the BPSS-AS-P. The psychometric properties of the BPSS-AS-P were evaluated, including internal consistency, convergent validity, and optimal cut-offs. Results Fifty-eight individuals (42.0 % of the second stage interviewees or 4.2 % of the total participants) were identified as being at risk of developing BD (BDRisk+). The median (IQR) age was 25 (20-30) and 24 (18-29) years, for the BDRisk+ and BDRisk- individuals. The BPSS-AS-P showed very good internal consistency (Cronbach's alpha=.89). The BPSS-AS-P raw summed total score was significantly positively correlated with BDRisk+ (P = .044), discriminating BDRisk+ from BDRisk- individuals (AUC=.800, P < .001) at a cut-off score= 25. Conclusions Among community-dwelling participants, prevalence of BDRisk+ individuals was 4.2 %. The BPSS-AS-P, a self-report questionnaire version of the semi-structured interview for identifying BDRisk+ individuals had satisfactory psychometric properties in a community sample. Future studies on the predictive validity of the BPSS-AS-P to predict full-blown BD are needed.

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